Why are bone and soft tissue measurements of the TT-TG distance on MRI different in patients with patellar instability?

Hinckel, Betina B.; Gobbi, Riccardo Gomes; Filho, Eduardo Noda Kihara; Demange, Marco Kawamura; Pécora, José Ricardo; Rodrigues, Marcelo Bordalo; Camanho, Gilberto Luís

doi:10.1007/s00167-016-4095-0

Cited by 24 publications

(19 citation statements)

References 41 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Significant differences had been shown in different trochlear groove measurements when using cartilaginous compared to bony landmarks 24 . Similarly, the patellar tendon centre had been reported to have a more lateral placement as compared to the tibial tuberosity, resulting in a larger PTTG 4,5 . In the present study, the difference between PTTG and TTTG values in the non-PFI group ranged from -4.4 to +6.4mm for all observers combined.…”

Section: Discussionmentioning

confidence: 99%

“…On the trochlear side also, it is the cartilaginous architecture of the trochlea that would better define the position of the patella and its tracking, rather than the underlying bony architecture 9,21,22 . The soft tissue landmarks of the patellar tendon and the deepest site of the cartilage in the trochlea, are the better anatomical and physiological landmarks compared with the bony landmarks, for an assessment of the lateralising vector force acting along the patellar tendon 4,9,10,23 . Significant differences had been shown in different trochlear groove measurements when using cartilaginous compared to bony landmarks 24 .…”

Section: Discussionmentioning

confidence: 99%

“…The chondral surface of the trochlear groove can also be easily demarcated in MRI and used in place of the underlying bony margins. Studies comparing TTTG and PTTG distances measured on MRI have found the patellar tendon to lie more lateral to the tibial tuberosity, resulting in larger PTTG distances 4,5 . Thus, the two distances may not be used interchangeably.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

A Comparison of the Reliability of the Patellar TendonTrochlear Groove (PTTG) Distance and the Tibial TuberosityTrochlear Groove (TTTG) Distance Measured on MRI

Gupta

Batta²,

Kataria

et al. 2020

Malays Orthop J

View full text Add to dashboard Cite

Introduction: An increased tibial tuberosity-trochlear groove (TTTG) distance is used for deciding a treatment plan in patello-femoral instability (PFI). The centre of the patellar tendon and the chondral trochlear groove can be directly visualised on MRI, and measured, giving the patellar tendontrochlear groove (PTTG) distance. A study was designed to compare the inter-rater and the test-retest reliabilities of PTTG and TTTG measurements in MRI of patients without PFI and in a group with PFI. Materials and Methods:This cross-sectional reliability study was done on archival MRI films of 50 patients without patellar instability and 20 patients with patellar instability. TTTG and PTTG distances were independently measured by two orthopaedic surgeons and two radiologists. A hybrid PTTG measurement with bony landmarks on the femoral side and the patellar tendon landmark on the tibial side, was used to estimate the influence of the differences in the femoral and tibial landmarks on the difference in reliabilities. The intra-class correlation coefficient (ICC) was calculated for all four raters, as well as separately for each rater. Results: The PTTG distance had a higher inter-rater reliability (ICC=0.86, 95% CI=0.79-0.92) compared to the TTTG distance (ICC=0.70, 95% CI=0.59-0.80) in patients without PFI. Similar trends were seen in patients with PFI (0.83 vs 0.66). The inter-rater reliability for the hybrid PTTG distance was found to lie in between the TTTG and PTTG. Conclusions: The MRI-based PTTG distance had better inter-rater reliability compared with the MRI-based TTTG distance.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

A Comparison of the Reliability of the Patellar TendonTrochlear Groove (PTTG) Distance and the Tibial TuberosityTrochlear Groove (TTTG) Distance Measured on MRI

Gupta

Batta²,

Kataria

et al. 2020

Malays Orthop J

View full text Add to dashboard Cite

show abstract

“…The medial patellofemoral ligament (MPFL), occupies for 50-60% of the total limiting force against LPD, which is generally considered to be the most important structure in medial soft tissue of the patellofemoral joint (1,7,8). However, several scholars have con rmed that the quadriceps muscle also plays an imperative role in maintaining the stability of the patella (9)(10)(11)(12). The vastus medialis obliquus (VMO) muscle, seems to be a vibrant dynamic stabilizer for neutralizing the lateral force of the patella, it's importance has been gradually recognized (9,13,14).…”

Section: Introductionmentioning

confidence: 99%

Morphological study of vastus medialis oblique in recurrent patellar dislocation based on magnetic resonance images

Shu

Yang

et al. 2020

Preprint

View full text Add to dashboard Cite

Purpose To investigate the morphological parameters of the vastus medialis obliquus (VMO) muscle and delineate its importance in the maintenance of patellofemoral joint stability.Methods The magnetic resonance imaging (MRI) data of 75 knees (54 patients) with recurrent lateral patella dislocation (LPD) and 75 knees (70 patients with similar age, gender and body mass index) were retrospectively analyzed. Five morphological parameters related to VMO (elevation on sagittal plane and coronal plane, cross-sectional area ratio, craniocaudal extent, muscle-fiber angulation,) and two parameters of patella tilt (patella tilt angle, bisect offset ratio) were measured in MRI images, and the types of trochlear in each patient were recorded. Finally, the differences of these parameters between the two groups were analyzed.Results Compared with the control group, the patients with recurrent LPD showed significantly higher in sagittal VMO elevation (10.4 ± 2.3 mm vs 4.1 ± 1.9 mm), coronal VMO elevation (15.9 ± 5.7 mm vs 3.9 ± 3.7 mm), muscle-fiber angulation (35.4 ± 8.0° vs 27.9 ± 6.3°), patella tilt angle (25.9 ± 10.7° vs 9.1 ± 5.2°), and bisect offset ratio values (0.9 ± 0.3 vs 0.5 ± 0.1), and significantly lower in craniocaudal extent (13.7 ± 5.3mm vs 16.7 ± 5.1 mm) and cross-sectional area ratio values (0.07 ± 0.02 vs 0.05 ± 0.02).Conclusions The results showed that the abnormality of VMO were clearly present in recurrent LPD patients compared with normal people, which may be an important factor of patella tilt in LPD patients, so it is necessary to focus on injury condition of VMO during preoperative evaluation.

show abstract

“…The medial patellofemoral ligament (MPFL) accounts for 50 -60% of the total limiting force against LPD, which is generally considered to be the most important soft tissue in the medial region of the patellofemoral joint (1,7,8). However, several scholars have con rmed that the quadriceps muscle also plays an imperative role in maintaining the stability of the patella (9)(10)(11)(12). The vastus medialis obliquus (VMO) muscle seems to be an important dynamic stabilizer for neutralizing the lateral force of the patella, and its importance is gradually being recognized (9,13,14).…”

Section: Introductionmentioning

confidence: 99%

Morphological study of the vastus medialis oblique in recurrent patellar dislocation based on magnetic resonance images

Shu

Yang

et al. 2020

Preprint

View full text Add to dashboard Cite

Background: To investigate the morphological parameters of the vastus medialis obliquus (VMO) muscle and delineate its importance in the maintenance of patellofemoral joint stability. Methods: The magnetic resonance imaging (MRI) data of 75 knees (54 patients) with recurrent lateral patella dislocation (LPD) and 75 knees (70 patients) without recurrent LPD were retrospectively analysed. Five morphological parameters related to the VMO (elevation in the sagittal plane and coronal plane, craniocaudal extent, muscle-fibre angulation, cross-sectional area ratio) and two patella tilt parameters (patella tilt angle, bisect offset ratio) were measured in MRI images. The independent-samples t test or chi-square test was used for statistical comparisons. Results: The mean ages of the patients in the recurrent LPD group and control group were 22.1 ± 9.9 years and 24.0 ± 6.5 years, respectively. MRI demonstrated that 24% (18 of 75) VMO injuries were found in recurrent LPD patients. Compared with the control group, the patients with recurrent LPD showed significantly higher sagittal VMO elevation (10.4 ± 2.3 mm vs 4.1 ± 1.9 mm), coronal VMO elevation (15.9 ± 5.7 mm vs 3.9 ± 3.7 mm), muscle-fibre angulation (35.4 ± 8.0° vs 27.9 ± 6.3°), patella tilt angle (25.9 ± 10.7° vs 9.1 ± 5.2°), and bisect offset ratio values (0.9 ± 0.3 vs 0.5 ± 0.1) and significantly lower craniocaudal extent (13.7 ± 5.3 mm vs 16.7 ± 5.1 mm) and cross-sectional area ratio values (0.05 ± 0.02 vs 0.07 ± 0.02). Conclusions: The results showed that abnormalities in the VMO and patella tilt were clearly present in recurrent LPD patients compared with normal people.

show abstract

Why are bone and soft tissue measurements of the TT-TG distance on MRI different in patients with patellar instability?

Abstract: III.

Cited by 24 publications

References 41 publications

A Comparison of the Reliability of the Patellar TendonTrochlear Groove (PTTG) Distance and the Tibial TuberosityTrochlear Groove (TTTG) Distance Measured on MRI

A Comparison of the Reliability of the Patellar TendonTrochlear Groove (PTTG) Distance and the Tibial TuberosityTrochlear Groove (TTTG) Distance Measured on MRI

Morphological study of vastus medialis oblique in recurrent patellar dislocation based on magnetic resonance images

Morphological study of the vastus medialis oblique in recurrent patellar dislocation based on magnetic resonance images

Contact Info

Product

Resources

About